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Sciatica refers to the pain felt along the sciatic nerve. The sciatic nerve travels from the lower back through the hips and buttocks and down each leg.
Depending on the symptoms and extent of the condition, sciatica can be categorized into 4 types: acute, chronic, bilateral, and alternative.
1. Acute sciatica
- Caused by sudden irritation to the nerves due to pinching, compression, or a combination of both.
- Symptoms may include:
- A burning or shooting sensation throughout the lower back, buttocks, and down the leg
- Hip pain
- Difficulty sitting as symptoms get worse
- Pain can last 1-2 weeks.
2. Chronic sciatica
- Can last months or years and may occur intermittently.
- Some conditions that can worsen the pain include:
- Inflammatory conditions, such as rheumatoid arthritis
- Injuries
- Infections
- Spinal misalignment issues
- May resolve temporarily but can recur without treatment or lifestyle and activity adjustments.
Bilateral sciatica
- A rare type of sciatica that affects both legs.
- May be caused due to multiple herniated discs or disc degeneration.
- The pain may be felt in both legs and buttocks at the same time.
- At times, pain in one leg might be more severe than pain in the other leg.
Alternative sciatica
- A rare type of sciatica that can cause pain in both legs alternatively.
- Can result from degenerative problems in the sacroiliac joint or sacroiliac arthritis.
What is neurogenic vs. referred sciatica?
Neurogenic sciatica
- Occurs when the sciatic nerve gets pinched, causing pressure along the spine.
- Symptoms may include:
- Sharp, shooting pain down the legs
- Weak legs
- Worsening pain in the legs when the issue is rooted in the spine
- As neurogenic sciatica causes abnormal nerve changes, it may also cause symptoms such as:
- Loss of reflexes
- Sensory issues
- Muscle weakness
- Tingling sensations
Referred sciatica
- Not a true form of sciatica but reflects pain and symptoms; the pain is related to muscle or joint problems.
- Symptoms of referred sciatica include:
- Dull or achy pain
- More severe pain in the back than in the legs
- Altered reflexes
- Sensory issues
- Tingling
How serious is sciatica?
The most common causes of sciatica are a herniated disc or a bone overgrowth that compresses a part of the nerve. Sciatica can result in inflammation, pain, and often numbness in one or both legs.
Although sciatica pain is severe, it usually clears up in a few weeks with appropriate treatment. Surgery is recommended in case of severe sciatica with leg weakness along with bowel or bladder changes.
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Home remedies are ideal for mild to moderate sciatica pain:
- Applying an ice pack to reduce pain and swelling and then switching to heat application.
- Taking over-the-counter painkillers, such as nonsteroidal anti-inflammatory drugs, to relieve pain and inflammation.
- Performing gentle stretches after learning them from authentic instructors.
If home treatments are ineffective even after 6 weeks, consult a healthcare professional about other treatment options, which may include:
- Prescription medicines such as muscle relaxants can relieve muscle spasms. Your physician may also prescribe tricyclic antidepressants and anti-seizure medications.
- Physical therapy involves exercises that mitigate sciatica by relieving pressure on the nerve. Exercise programs may include:
- Stretching exercises can improve muscle flexibility
- Aerobic exercises can improve the overall health
- Spinal injections using corticosteroids into the lower back can reduce pain around the affected area.
- Alternative therapies, such as acupuncture, massage, and biofeedback can be effective.
- Surgery may be considered the last resort when other therapies have failed. Surgery options may include:
- Microdiscectomy to remove fragments of herniated disc compressing the nerve
- Laminectomy to remove a part of the vertebral bone called the lamina, which may cause pressure on the sciatic nerve
https://my.clevelandclinic.org/health/diseases/12792-sciatica
https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-2037743
https://www.sciencedirect.com/topics/medicine-and-dentistry/sciatica
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